Obstructive Sleep Apnea Increases Sudden Cardiac Death in Incident Hemodialysis Patients

Mortality in end-stage renal disease (ESRD) occurs predominantly from cardiovascular disease (CVD) and sudden cardiac death (SCD). Obstructive sleep apnea (OSA) is characterized by periodic airflow limitation associated with sleep arousal and oxygen desaturation and is prevalent in patients with ESR...

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Vydané v:	American journal of nephrology Ročník 48; číslo 2; s. 147
Hlavní autori:	Kerns, Eric S, Kim, Esther D, Meoni, Lucy A, Sozio, Stephen M, Jaar, Bernard G, Estrella, Michelle M, Parekh, Rulan S, Bourjeily, Ghada
Médium:	Journal Article
Jazyk:	English
Vydavateľské údaje:	Switzerland 01.01.2018
Predmet:	Aged Cause of Death Comorbidity Coronary Disease - etiology Coronary Disease - mortality Death, Sudden, Cardiac - etiology Female Follow-Up Studies Humans Kaplan-Meier Estimate Kidney Failure, Chronic - complications Kidney Failure, Chronic - mortality Kidney Failure, Chronic - therapy Male Middle Aged Prevalence Prospective Studies Renal Dialysis Sleep Apnea, Obstructive - complications Sleep Apnea, Obstructive - epidemiology Surveys and Questionnaires - statistics & numerical data Cardiovascular death Cardiovascular disease Sudden cardiac death Hemodialysis Obstructive sleep apnea
ISSN:	1421-9670, 1421-9670
On-line prístup:	Zistit podrobnosti o prístupe
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Popis
Shrnutí:	Mortality in end-stage renal disease (ESRD) occurs predominantly from cardiovascular disease (CVD) and sudden cardiac death (SCD). Obstructive sleep apnea (OSA) is characterized by periodic airflow limitation associated with sleep arousal and oxygen desaturation and is prevalent in patients with ESRD. Whether OSA increases the risk for SCD, cardiovascular and all-cause mortality among hemodialysis patients remains unknown. In a prospective cohort of 558 incident hemodialysis patients, we examined the association of OSA with all-cause mortality, cardiovascular mortality, and SCD using Cox proportional hazards models controlling for traditional CVD risk factors. Sixty-six incident hemodialysis patients (12%) had OSA. Mean age (56 years) and percentage of males (56%) were identical in OSA and no-OSA groups. Fewer African Americans had OSA than non-African Americans (9 vs. 18%, respectively). Participants with OSA had higher body-mass index, Charlson comorbidity score, and left ventricular mass index and greater prevalence of diabetes and coronary artery disease. During 1,080 person-years of follow-up, 104 deaths occurred, 29% of which were cardiovascular. OSA was associated with a higher risk of all-cause mortality (HR 1.90 [95% CI 1.04-3.46]) and cardiovascular mortality (HR 3.62 [95% CI 1.36-9.66]) after adjusting for demographics and body-mass index. OSA was associated with a higher risk of SCD after adjusting for demographics (HR 3.28 [95% CI 1.12-9.57]) and multiple cardiovascular risk factors. Incident hemodialysis patients with OSA are at increased risk of all-cause and cardiovascular mortality and SCD. Future studies should assess the impact of screening for OSA and OSA-targeted interventions on mortality in ESRD.
Bibliografia:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 ObjectType-Undefined-3
ISSN:	1421-9670 1421-9670
DOI:	10.1159/000489963